A drug used to treat schizophrenia may be a new tool to help patients with anorexia gain weight and control their obsessive thoughts about food.
New Canadian research has found that when anorexia patients take olanzapine, they gain weight, feel calmer and do not have the obsessive thoughts about weight and food that characterize the debilitating condition.
The research was led by Dr. Hany Bissada, a psychiatrist at and director of The Ottawa Hospital Regional Centre for the Treatment of Eating Disorders. The study included 34 women with anorexia who were enrolled in the centre's day program for anorexia treatment.
Patients were given either a placebo or the anti-psychotic drug olanzapine, one of the side effects of which is weight gain.
The findings are published in the American Journal of Psychiatry.
The researchers caution that the drug is not a cure for the disease. Patients with anorexia need counselling and often have to work with a dietitian or nutritionist.
However, the medication allows patients to be more open to getting treatment.
"It is an important finding because, for the first time, it gives us hope to say there is a medication because even though it is not a cure, it can help facilitate treatment for anorexia nervosa," Bissada told Â鶹´«Ã½.
Anorexia nervosa affects about 0.5 per cent of women between the ages of 15 and 24.
Patients become obsessed with being thin and have a fear of being overweight. They become emaciated, which can lead to a number of health problems. Patients often don't believe they have a problem.
"Denial is a big part of the illness," Dr. Wendy Spettigue of the Children's Hospital of Eastern Ontario told Â鶹´«Ã½. "So patients often don't recognize it and, if they do, they are often too afraid to get treatment."
Anorexia is the most fatal of all psychiatric disorders.
Debbie Wiseman was one of the study participants. Before enrolling she weighed 69 pounds. She felt fat, unpopular and was afraid that anything she ate would make her gain weight.
"It came to a point where I wanted to die because I was not happy with myself," Wiseman told Â鶹´«Ã½.
After she started taking olanzapine, she began to gain weight and feel happier. And she noticed that she was no longer afraid to have a piece of pizza or a chocolate bar.
Now she is a healthy 115 pounds, and she believes the drug is directly responsible for her improvement.
"If I didn't take it I don't know that I'd be here today," Wiseman said.
With a report from CTV medical specialist Avis Favaro and senior producer Elizabeth St. Philip
Abstract:
Olanzapine in the Treatment of Low Body Weight and Obsessive Thinking in Women With Anorexia Nervosa: A Randomized, Double-Blind, Placebo-Controlled Trial
Hany Bissada, M.D., Giorgio A. Tasca, Ph.D., Ann Marie Barber, M.A., and Jacques Bradwejn, M.D.
OBJECTIVE: Anorexia nervosa is associated with high mortality, morbidity, and treatment costs. Olanzapine, an atypical antipsychotic, is known to result in weight gain in other patient populations. The objective of this trial was to assess the efficacy of olanzapine in promoting weight gain and in reducing obsessive symptoms among adult women with anorexia nervosa.
METHOD: The study was a double-blind, placebo-controlled, 10-week flexible dose trial in which patients with anorexia nervosa (N=34) were randomly assigned to either olanzapine plus day hospital treatment or placebo plus day hospital treatment.
RESULTS: Compared with placebo, olanzapine resulted in a greater rate of increase in weight, earlier achievement of target body mass index, and a greater rate of decrease in obsessive symptoms. No differences in adverse effects were observed between the two treatment conditions.
CONCLUSIONS: These preliminary results suggest that olanzapine may be safely used in achieving more rapid weight gain and improvement in obsessive symptoms among women with anorexia nervosa. Replication, in the form of a large multicenter trial, is recommended.
(requires registration)